Anorexia Nervosa (cont.)

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Most individuals with anorexia become obsessed with food
and thoughts of food. They think about it constantly and become compulsive about
their food choices or eating rituals. They may collect recipes, cut their food into tiny pieces,
prepare elaborate calorie-laden meals for other people, or hoard food.
Additionally, they may exhibit other obsessions and/or compulsions related to
food, weight, or body shape that meet the diagnostic criteria for an
obsessive compulsive disorder.

Other psychiatric problems are also common in people with anorexia nervosa, including affective (mood) disorders, anxiety disorders, and personality disorders.

Generally, individuals with anorexia are compliant in every other aspect of their life except for their relationship with food. Sometimes, they are overly compliant, to the extent that they lack adequate self-perception. They are
often eager to please and strive for perfection. They usually do well in school and may often overextend themselves in a variety of activities. The families of anorexics often appear to be "perfect." Physical appearances are important to the
anorexia sufferer. Performance in other areas is stressed as well, and they are often high achievers
in many areas.

While control and perfection are critical issues for
individuals with anorexia, aspects of their life other than their eating habits are often
found to be out of control as well. Many have, or have had at some point in
their lives, addictions to alcohol, drugs, or gambling. Compulsions involving
sex, exercising, housework, and shopping are not uncommon. In particular, people
with anorexia often exercise compulsively to speed the
weight-loss process.

Symptoms of anorexia in men tend to co-occur with other psychological problems and more commonly follow a period of being overweight than in women. Men with anorexia also tend to be more likely to have a distorted body image.

Compared to symptoms in men, symptoms of anorexia in women tend to more frequently include a general displeasure with their body and a possibly stronger desire to be thin. Women with anorexia also tend to experience more perfectionism and cooperativeness.

In addition to the mental effects of anorexia, physical effects of this disorder in children and teens include a number of issues that are associated with growth and development inherent in this age group. Examples of symptoms and signs of anorexia in childhood and adolescence can include a slowing of the natural increase in height or a slowed development of other body functions like menses.

All of these features can negatively affect one's daily activities. Diminished interest in previously preferred activities can result or worsen. Some individuals also have symptoms that meet the diagnostic criteria for a major depressive disorder.